The best birth control if you don’t want to have children are in order from best/most to least effective:

The birth control implant (Nexplanon ®) works better than tubal ligation! Some women do GREAT on it. Some women have a lot of random breakthrough bleeding (BTB).

The IUD with hormone (Mirena ®, Liletta ®, Kyleena ®, Skyla ®) are very well tolerated because it is low dose and progesterone only. 30% of women who go on Mirena and Liletta have no periods. yay! 70% get lighter periods. Kyleena and Skyla are more likely to continue to have periods.

Then comes, Tubal ligation and then copper IUD in terms of efficacy at preventing pregnancy.

If you like the birth control ring (Nuvaring ® or its generics), now there is a 1 year ring. You could just put it in and leave it in for a year!!

Know that there are 40 different birth control pills with estrogen and progesterone. so if you didn’t like 1 then there are 39 other formulations of the birth control pill you could try.

If you are in a long term heterosexual relationship that never wants children, it’s better for the one with the testicles to get a vasectomy than the one with the uterus to have that person’s tubes tied. Vasectomy is more effective and less invasive than tubal ligation. Tubal ligation is invasive! they have to poke 3 holes in your abdomen, blow it up with gas. and it’s NOT as effective as the implant/IUD with hormone! and NOT as effective as vasectomy.

If your doctor is an ob/gyn or even if they are not, you can cite the ACOG committee opinion it says:

“It is ethically permissible to perform a requested sterilization in nulliparous women and young women who do not wish to have children. A request for sterilization in a young woman without children should not automatically trigger a mental health consultation. Although physicians understandably wish to avoid precipitating sterilization regret in women, they should avoid paternalism as well.”

The 5-7 yr IUD with hormone fails 1/1000.

The implant fails 1/1000.

Vasectomy fails 1.5/1000.

Tubal ligation/women’s sterilization fails 5/1000

Copper IUD fails 8/1000

The birth control ring, the birth control patch, and the birth control pill fail 7/100, though the ring and patch, should have a theoretical lower failure rate because you have fewer chances of forgetting/messing up. The ring has 13 chances a year of messing up, the patch 52 times and the pill 365 times.

You can read more about birth control effectiveness or what’s the best birth control for you in our resources.

updated 11.5.20